Presentation
The author presents two patients suffering from brachioradial pruritus who were treated with thalidomide and presented excellent results. This paper aims to suggest a new therapeutic option for this refractory disease. [scielo.br]
Neuropathic pruritus can present clinically as brachioradial pruritus or notalgia paresthetica. Showing page 1. Found 4 sentences matching phrase "Brachioradial pruritus".Found in 1 ms. [glosbe.com]
A total of 58 consecutive patients presenting at the Center for Chronic Pruritus, University Hospital Münster, were analysed with regard to clinical presentation, anatomical and morphological pathologies, impairment in quality of life, and response to [read.qxmd.com]
Cervical magnetic resonance imaging should be performed if the onset is recent or neurologic deficits are present. The region around the C5 and C6 nerve roots, in particular, should be analyzed. [dermatologyadvisor.com]
We present a patient with brachioradial pruritus and a review of the literature. [mdedge.com]
Entire Body System
- Burning Pain
Additional features of the dermatologic condition may include localized burning, pain, tenderness, hyperalgesia, or dysesthesias. BRP tends to be a chronic condition with periodic remissions and exacerbations. [lagunaskincenter.com]
A 53-year-old female patient presented with pruritus and burning pain on the hands and feet, that had extended progressively up to the elbows and knees over 7 years. [medicaljournals.se]
In addition, it was found that in patients with neuropathic pain, histamine ionophoresis resulted in a sensation of burning pain rather than itch, which would be induced in normal healthy patients. [care.diabetesjournals.org]
Musculoskeletal
- Neck Pain
Some patients reported neck pain. in the skin of the lower arm, the number of protein gene product 9.5 immunoreactive nerve fibers was reduced 23% as compared with controls (P = .03), the number of intraepithelial nerve fibers being reduced by 27% (P [portal.research.lu.se]
Some patients reported neck pain. [en.wikipedia.org]
Some patients reported neck pain. BRP can be linked to the thyroid. [howtoorganizefeelings.blogspot.com]
- Osteophyte
Epidural cervical steroid injections at the C6-7 level were reported to lead to disappearance of itch in a patient with brachioradial pruritus. [13] Cervical spine tumors, [25] cervical ribs, hypertrophic cervical transverse processes, [26] and cervical osteophytes [emedicine.medscape.com]
Magnetic resonance imaging of her cervical spine revealed a left-sided osteophyte causing minimal left neural foraminal stenosis at the level of C3 to C4 (Figure). [mdedge.com]
Neurologic
- Radiculopathy
Despite the high frequency of cervical spine abnormalities on imaging, nearly all brachioradial pruritus patients imaged did not meet the criteria for cervical radiculopathy. [ncbi.nlm.nih.gov]
Exposure of the affected areas to sun and wind may precipitate an episode, as may radiculopathy of the cervical spine. Despite the severity of symptoms, no associated erythema or skin eruption is seen. [beijingacu.com]
However, in eight patients (26%), the neurologists suggested that BRP could be attributed to radiculopathy or peripheral neuropathy. [onlinelibrary.wiley.com]
BRP may be attributed to a neuropathy, such as chronic cervical radiculopathy. The possibility of an underlying neuropathy should be considered in the evaluation and treatment of all patients with BRP. [en.wikipedia.org]
- Neuralgia
Botulinum toxin and intractable trigeminal neuralgia. Clin Neuropharmacol 2005;28:161-2. 23. Szepietowski JC Wąsik G Notalgia paresthetica: a rare manifestation of localized pruritus. Przegl Dermatol 2002;89:215-7. [content.sciendo.com]
A new capsaicin 8% dermal patch has proven effective against pruritus in patients with post-herpetic neuralgia (2). [medicaljournals.se]
Pruritus Aka: Brachioradial Pruritus, Brachioradialis Pruritus, Actinic Brachioradial Neuralgia From Related Chapters II. Epidemiology Affects Caucasians living in tropical regions More common in middle-aged women III. [tripdatabase.com]
In the treatment of post-herpetic neuralgia, one study demonstrated the use of a higher dose of amitriptyline 4% and ketamine 2% to be effective [13]. [cureus.com]
Trigeminal neuralgia, trophic ulceration and the plastic surgeon. J R Coll Surg Edinb 1998; 43:185–188. PubMed CAS Google Scholar Mayer RD, Smith NP. [link.springer.com]
- Dysesthesia
There are multiple types of dysesthesias depending on the body location and the nerves involved. [read.qxmd.com]
Additional features of the dermatologic condition may include localized burning, pain, tenderness, hyperalgesia, or dysesthesias. BRP tends to be a chronic condition with periodic remissions and exacerbations. [lagunaskincenter.com]
Introduction Brachioradial pruritus (BRP) is a localized neuropathic dysesthesia of the dorsolateral upper extremities. It is commonly seen in middle-aged white females with a seasonal predilection for warmer summer months. [ncbi.nlm.nih.gov]
- Myelopathy
In many cases, brachioradial pruritus is clearly due to nerve damage or radiculopathy in the cervical spine (neck), when it may be due to: Cervical vertebral osteoarthritis Cervical rib Cervical spinal tumour Nerve compression or myelopathy for any other [dermnetnz.org]
[…] fibres within the skin In many cases, brachioradial pruritus is clearly due to nerve damage or radiculopathy in the cervical spine (neck), when it may be due to: Cervical vertebral osteoarthritis Cervical rib Cervical spinal tumour Nerve compression or myelopathy [allsortsofsoap.com]
In only one case was a patient referred to a neurosurgeon, who advised against surgery due to lack of myelopathy. Therefore, in no patient was neurosurgery recommended. [onlinelibrary.wiley.com]
- Paresis
We describe the case of a 60-year old woman recently diagnosed with multiple myeloma who refers paresis, severe pruritus and itching lesions on the right arm with 6 months of evolution. [read.qxmd.com]
Workup
Further workup, such as imaging, labs, and referral to specialists is rarely required. Therapeutic options are numerous and well-tolerated. [ncbi.nlm.nih.gov]
And you should never just dismiss a very persistent symptom—even if it seems like no big deal—without a proper workup. Below are some reasons you may be feeling itchy, even when there is no rash present. 1. [self.com]
X-Ray
- Cervical Spine X-Ray
Expected results of diagnostic studies Routine cervical spine X-rays are advisable to check for structural lesions. Cervical magnetic resonance imaging should be performed if the onset is recent or neurologic deficits are present. [dermatologyadvisor.com]
Treatment
Shorter treatment durations were associated with worse perceptions of reduction (χ2; p=0.0004). Higher intensities of pruritus prior to treatment were associated with excellent reduction after treatment (KW; p=0.0376) (Figure 1b). [scielo.br]
Mean inpatient treatment costs were reduced by €212.31, and mean outpatient treatment and medication costs by €100.74 per patient (p.p.). [tripdatabase.com]
Cutaneous Field Stimulation in the Treatment of Severe Itch. Arch Dermatol. 2001;137:1232-1325. doi:10.1001/archderm.137.10.1323. Stellon A. Neurogenic pruritus: An unrecognised problem? A retrospective case series of treatment by acupuncture. [jofskin.org]
Other treatments of neuropathic pain and itching, including capsaicin, amitriptyline, and gabapentin, can sometimes be successful. 5, 12, 13 Many patients are refractory to multiple treatments. [ncbi.nlm.nih.gov]
Prognosis
What is the prognosis (outlook) for itching? Itching itself is not associated with long-term skin problems or harm, and most cases of itch are temporary and resolve on their own or with topical or oral treatments. [medicinenet.com]
Etiology
Often described as dermatologic syndromes, both diseases are typically considered to be multifactorial in etiology with an uncertain etiology... [read.qxmd.com]
History and Physical Because pruritus has many etiologies, a thorough history is essential to avoid unnecessary testing and delay in treatment. [ncbi.nlm.nih.gov]
It is likely that the etiology of BRP is not uniform and both of the above factors contribute to varying degrees in different patients. [dermatologyadvisor.com]
Aimee Szewka, Michael Gibbs, Jonathan Cheponis, Steven Lewis First published April 4, 2016, Abstract OBJECTIVE: To report three cases of brachioradial pruritus (BRP), describe the typical clinical presentation and epidemiology, and discuss possible etiology [n.neurology.org]
Some of the current systemic therapies may in fact exert their effect through the spinal nerves and central nervous system thereby supporting the neuropathic etiology of BRP( Brachioradial Pruritus). [lagunaskincenter.com]
Epidemiology
86 (16 Supplement) April 18, 2016 Aimee Szewka, Michael Gibbs, Jonathan Cheponis, Steven Lewis First published April 4, 2016, Abstract OBJECTIVE: To report three cases of brachioradial pruritus (BRP), describe the typical clinical presentation and epidemiology [n.neurology.org]
The emergence of brachioradial pruritus cases in temperate climates has further contributed to research efforts to discover more about the epidemiology of this neurocutaneous condition. [wisegeek.com]
Epidemiology Early isolated case reports suggested that brachioradial pruritus was more common in males. Later larger studies revealed that brachioradial pruritus is seen more commonly in females than males in a ratio 3:1. [ncbi.nlm.nih.gov]
Epidemiology Affects Caucasians living in tropical regions More common in middle-aged women III. Pathophysiology: Postulated Mechanisms with nerve compression Prolonged ultraviolet light exposure (e.g. tropics) IV. [tripdatabase.com]
Pinto ACVD, Masuda PY, Wachholz PA, Carlos A, Martelli C. clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology. An Bras Dermatol. 2016;91(4):549-551. Mirzoyev SA, Davis MDP. [jofskin.org]
Pathophysiology
In view of the literature, a definitive pathophysiology for brachioradial pruritus does not exist. It is clear that it is a unique clinical entity, but the pathophysiologic basis is not known. [mdedge.com]
Pathophysiology: Postulated Mechanisms with nerve compression Prolonged ultraviolet light exposure (e.g. tropics) IV. [tripdatabase.com]
[…] supporting the solar hypothesis Many patients with brachioradial pruritus have a history of chronic sun exposure. [2, 14, 15] Kestenbaum and Kalivas [16] postulated that histamine release from mast cells in response to chronic sun exposure might play a pathophysiologic [emedicine.medscape.com]
Recent advances in pathophysiology and current management of itch. Ann Acad Med Singapore 2007;36:788-92 7. Wallengren J. Brachioradial pruritus: a recurrent solar dermopathy. J Am Acad Dermatol 1998;39:803-6. 8. Wallengren J Sundler F. [content.sciendo.com]
The lack of primary skin lesions in brachioradial pruritus in addition to its poorly established pathophysiology can often lead to both diagnostic and therapeutic challenges for many physicians. [read.qxmd.com]
Prevention
Prevent the condition from worsening In Australia, most cases result from sun damage to sensory nerves and sun protection to prevent summertime worsening is important. [dermcoll.edu.au]
The best way to prevent pruritus is to take care of your skin. To protect skin: Use skin creams and lotions that moisturize your skin and prevent dryness. Use sunscreens regularly to prevent sunburns and skin damage. [webmd.com]
Source: iStock Is it possible to prevent itching? Itching can be prevented only to the extent that the underlying cause(s) of the itching sensation can be prevented. [medicinenet.com]
[…] initially diagnosed on the appearance of symptoms, but other testing is required to determine the causative factor, including radiological, imaging, nerve testing, and Skin biopsy Treatment *Treatment is not always successful *Goal of treatment is to prevent [ozarkderm.com]
Targeting these damaged nociceptors and preventing them from firing can potentially lead to symptomatic improvement. [cureus.com]